Dentistry Factors in Prosthodontics

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Questions and Answers

What is one way to help an anxious patient during dental procedures?

Reassure and encourage relaxation. (correct)

Encourage them to discuss their fears loudly.

Move quickly to minimize their time in the chair.

Tell them to breathe deeply through their mouth.

Which position should the dental chair be adjusted to for patient comfort?

Laid flat position.

Reclined position.

Upright position. (correct)

Semi-reclined position.

Why is nasal breathing encouraged during dental procedures?

It reduces the likelihood of retching. (correct)

It increases saliva production.

It helps the dentist hear the patient's concerns.

It allows the patient to talk comfortably.

What type of impression tray is generally more comfortable for patients?

Well-fitting special trays. Signup and view all the answers

When should the lower dental impression be taken?

Before any upper impressions. Signup and view all the answers

What should the dentist do with the impression material before trying it in?

Mix or prepare it out of sight of the patient. Signup and view all the answers

What should be done if there are copious amounts of saliva in the mouth during the procedure?

Use a saliva ejector. Signup and view all the answers

What type of movements should be used when trying trays in the mouth?

Firm, positive movements. Signup and view all the answers

What is a key factor in managing a patient's apprehension during dental procedures?

The dentist's confident and relaxed chairside manner Signup and view all the answers

Which factor is considered a psychogenic cause of dental retching?

Past negative experiences with dental care Signup and view all the answers

What may contribute to retching in patients with persistent catarrh?

Inability to breathe through the nose Signup and view all the answers

What should a dentist do when assessing a patient experiencing retching?

Take a careful history to understand the severity Signup and view all the answers

What type of factors may cause dental retching unrelated to dental treatment?

Systemic diseases affecting the gastrointestinal tract Signup and view all the answers

How can retching during impression taking be minimized?

Providing reassurance and promoting relaxation Signup and view all the answers

What is often the best initial approach for correcting issues with denture wear?

Correcting errors in denture design Signup and view all the answers

Overcoming retching in dental settings primarily requires understanding which aspect?

Patient's psychological state Signup and view all the answers

What anatomical factor may require a deep notch in the flange of a denture?

Prominent labial frenum Signup and view all the answers

Which factor can contribute to high occlusal loads in patients?

Bruxism Signup and view all the answers

What is a common cause of weak bonding between teeth and denture bases?

Residual wax on the ridge-lap surface Signup and view all the answers

What recommendation is widely supported for minimizing the risk of debonding?

Choosing compatible artificial teeth and denture base polymer Signup and view all the answers

What can help increase the bond strength between the denture base resin and the artificial teeth?

Drilling small channels into the palatal surface Signup and view all the answers

What type of teeth generally achieves higher bond strength with denture bases?

Conventional denture teeth Signup and view all the answers

Which substance is recommended for application on the ridge-lap surface to enhance bonding?

Dichloromethane Signup and view all the answers

What is a potential issue when drilling channels into the ridge-lap surface of teeth?

It complicates wax removal Signup and view all the answers

What consequence may arise from excessive palatal thickening in the canine region?

Disturbance in speech. Signup and view all the answers

Which sounds require contact between the lower lip and the incisal edges of the upper anterior teeth?

/f/ and /v/ Signup and view all the answers

What is necessary to produce the English consonants with the lateral margins of the tongue?

Contact with the posterior teeth. Signup and view all the answers

What condition may arise if the posterior contact surfaces are positioned too far from the resting position of the tongue?

Lateral sigmatism. Signup and view all the answers

During which sounds does the mandible move closest to the maxilla?

/s/, /z/, /ch/, and /j/ Signup and view all the answers

What might occur if the occlusal vertical dimension of dentures is too great?

The teeth may come into contact during speech. Signup and view all the answers

What may be a direct result of the posterior teeth being too far buccally positioned?

Difficulties in forming specific sounds. Signup and view all the answers

Which sounds do not require the lateral margin of the tongue to contact the posterior teeth?

/h/ Signup and view all the answers

What is a recommended way to distract a patient during the insertion of an impression?

Talking about topics of interest to the patient Signup and view all the answers

Which method is NOT mentioned as a management approach for patients with a severe gagging reflex?

Medication Signup and view all the answers

What is a potential benefit of hypnosis for patients who have a strong gag reflex?

It may allow the patient to wear the denture outside the dental surgery Signup and view all the answers

How does acupuncture help with the gag reflex according to the strategies outlined?

It assists during dental procedures Signup and view all the answers

What is the purpose of using a training denture in patients with a history of denture intolerance?

To facilitate a gradual adjustment to wearing dentures Signup and view all the answers

Which technique relies on the patient's ability to practice self-management?

Hypnosis Signup and view all the answers

What should a dentist reinforce during the setting period of an impression?

The need for slow and steady breathing Signup and view all the answers

Which situation presents the first major challenge in denture construction for patients with a severe gag reflex?

Achieving an accurate impression Signup and view all the answers

Study Notes

Patient Factors in Denture Construction

Anatomical issues, such as a prominent labial frenum, necessitate a deep notch in the flange that can create stress concentrations.
High occlusal loads arise from strong masticatory muscles, remaining natural teeth, or bruxism, which can compromise denture stability.

Debonding of Teeth

Weak bonds between tooth and denture base can result from:
- Residual tin-foil substitute on the ridge-lap surface.
- Residual wax on tooth surfaces.
- Incompatibility of cross-linked teeth with denture base polymers.
Recommendations to minimize debonding risk include:
- Selection of compatible artificial teeth and denture base polymers, favoring conventional denture teeth for higher bond strength.
- Complete removal of wax and tin-foil substitutes; using a wax solvent is suggested for optimal results.
- Drilling small channels in the palatal tooth surface to enhance bonding area, though care is required to avoid trapping wax.
- Application of solvents like dichloromethane for improved adhesion.

Psychogenic Factors

Psychological causes of retching can stem from sensory triggers associated with dental procedures, apprehensions from prior bad experiences, or distressing stories from others.
Rarely, retching may indicate a psychological disturbance unrelated to dental treatment.

Systemic Factors

Systemic diseases, particularly gastrointestinal issues, can contribute to symptoms like retching.
Persistent catarrh may lead to difficulty in nose breathing, exacerbating retching issues.

Patient Management

Severity assessment involves a detailed history to pinpoint causes; issues tolerated during denture construction but not during wearing might suggest design errors.
Impression-taking techniques to prevent retching:
- Reassurance and a calm chairside manner are essential to ease patient anxiety.
- Patients should be seated comfortably upright.
- Instructing nasal breathing during procedures helps maintain a stable soft palate and tongue position.
- Use well-fitting, close-fitting special trays instead of bulky ones; lower impressions may provide patient success and confidence.
- Keep impression material preparation out of patient's sight and minimize quantity.

Distraction Techniques

Engaging patients in conversation about their interests or techniques like focusing on breathing can divert attention from anxiety during procedures.

Management of Severe Gag Reflex

Techniques for handling gag reflex challenges include:
- Conscious sedation to alleviate anxiety.
- Acupuncture may help control the gag reflex during procedures.
- Hypnosis can be beneficial if patients are motivated and able to practice self-hypnosis.
- Training dentures may assist patients with historical difficulties related to denture intolerance.

Impact on Speech and Denture Design

Lower lip contact with upper anterior teeth affects sounds /f/ and /v/ when teeth positions differ from previous dentures, potentially disrupting speech.
The lateral margins of the tongue must contact posterior teeth for producing English consonants; poor placement may restrict tongue movement and impair speech.
Proper mandible-maxilla relationships are crucial; excessive occlusal vertical dimension can lead to tooth clattering during specific speech sounds.

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Description

Explore the critical patient factors influencing denture design in this quiz. From anatomical aspects like the labial frenum to occlusal load considerations in patients, understand how these factors affect the bond between tooth and denture base. Ideal for dental students and practitioners alike.